Provider Demographics
NPI:1467289751
Name:TODD, SHAWNA L (L,AC)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:L
Last Name:TODD
Suffix:
Gender:F
Credentials:L,AC
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:L
Other - Last Name:TODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHAWNA TODD L,AC
Mailing Address - Street 1:220 W MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1765
Mailing Address - Country:US
Mailing Address - Phone:970-300-8251
Mailing Address - Fax:
Practice Address - Street 1:220 W MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1765
Practice Address - Country:US
Practice Address - Phone:970-300-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114886171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist